Intensive care needed for health care solution

MIRZA
Dr. Wasique Mirza is an internist who has been practicing medicine in Scranton for 13 years.
He is the chief medical officer at Scranton Primary Healthcare Center and a clinical faculty member of the Wright Center and the Commonwealth Medical College.

We have a very dysfunctional health care system. Despite its recent relegation to a leper status, it was heartening to see it return as a major issue for discussion during the presidential debates. In addition to a total disagreement between the two sides, here are a few major issues:

- Lack of adequate and or affordable coverage.

- Unwillingness of the insurance companies to expand affordable plans.

- Expensive prescribing habits of paranoid physicians.

- Spoiled health care beneficiaries.

- Lack of accountability and an adequate tort reform.

- Failure on the part of our representatives to recognize the importance of health care reform.

Imagine a perfect society where the government works solely for the benefit of the people; political gains, dashboard forecasts and corporate lobbies are just an afterthought. In that system, bills are presented and subsequently passed, not on the basis of party lines but for the fact that there is a true need by the people. So, in that perfect system, health care will get the due attention that it truly deserves and a bipartisan commission will be created. Members of this commission include:

- Three members of the House and two senators from each side of the floor, selected for their knowledge and expertise in health care and economy

- Two leading economists and health care policy experts, one of each nominated by the DNC and GOP.

- Secretary of health and human services or a senior authorized representative.

- Two members of National Governors Association. One Republican and one Democrat.

- Any member of the commission with direct links to any beneficiary group or lobbies (American Medical Association, trial lawyers, insurance and pharmaceutical lobbies, etc.) will be automatically disqualified.

Once established, the sole responsibility of this commission will be to come up with a solution to our health care problems. There will be a solid deadline for the presentation of a draft, which will be final. The commission will be sequestered during the deliberations with no access to any outside pressures, media or otherwise. Any leaks will result in immediate removal.

This is the only possible way the partisan attitudes of the Congress can be overcome. If this works, it can be expanded to tackle other issue of national importance so that the juvenile infighting of grown men and women has the least impact on decisions that we cannot afford to delay.

Despite being landmark legislation, the current shape of the Affordable Care Act has many flaws. Unfortunately, these flaws are a direct result of partisan pressures from both sides of the aisle, influenced by strong lobbies.

The result is a lukewarm effort to tackle one of the most critical domestic challenges that we face outside of the economy. Despite the mandate promising health care coverage, there is still no clear evidence that the private sector will oblige and lower the rates so small businesses and patients are able to afford the premiums.

In anticipation of this, the insurance companies have already tightened the noose around their coverage as medications, investigations and treatment plans have become increasingly more difficult to get approved. Fiscal responsibilities aside, the tedious process is the first deterrent and makes it extremely frustrating for health care providers to proceed with a treatment plan.

Unfortunately, all this is being done without adequately educating the patients about their responsibilities. This task now solely rests on the shoulder of the shrinking force of primary care providers, already burdened by the increasing cost-reimbursement ratio.

Health care providers, however, are not the innocent victims either. The paranoia that surrounds them, stemming from the fear of a lawsuit, drives them to frenzy when prescribing medications and tests, which on most occasions are more to protect themselves and pacify patient demands rather than leaning on clinical indications.

Despite my own recognition of this habit, and its impact on health care spending, I am at times as guilty of unnecessary caution as the next guy. A tort reform that safeguards the rights of the patients as well as health care providers, giving them a sense of security and confidence in exercising their reasonable clinical judgment, is a must, and its conspicuous absence in Obamacare is a cause of concern.

In addition, with the help of insurance companies and, especially, Big Pharma (using a part of their direct-to-patient advertising budget), better education of health care beneficiaries, so they fully understand that expensive testing is not necessarily the best way to improved health, is vital in order to achieve a more responsible and health care conscious society.

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